D439 FOUNDATIONS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
SBAR Format - CORRECT ANSWER✔✔--model for effective
| | | | | | |
communication identifying Situation, Background, Assessment, and | | | | | |
Recommendation
-there are two types of ways that communication tools are used to
| | | | | | | | | | | |
communicate a patients change in condition: CUS tool (Concerned,
| | | | | | | | |
Uncomfortable, Safety) and SBAR | | |
-note to always maintain pt privacy and confidentiality
| | | | | | |
SBAR EXAMPLE : | |
Case Study: You administered 1 tablet of oxycodone HCl 5 mg/ibuprofen
| | | | | | | | | |
400 mg PO to a patient 30 minutes ago for postsurgical pain. You return
| | | | | | | | | | | | | | |
to the patient's room to evaluate the effectiveness of the medication 30
| | | | | | | | | | | |
minutes later. The patient rates his pain as an 8 on a scale of 0-10. You
| | | | | | | | | | | | | | | |
use SBAR to contact the patient's health care provider.
| | | | | | | |
Situation: The patient is rating his pain as an 8 on a scale of 0-10. He
| | | | | | | | | | | | | | | | |
had his pain medication 30 minutes ago.
| | | | | |
,|Background: The patient had a knee replacement and returned from
| | | | | | | | | |
the postanesthesia care unit 6 hours ago. He has 1 tablet of oxycodone
| | | | | | | | | | | | |
HCl 5 mg/ibuprofen 400 mg PO ordered every 6 hours. This is the first
| | | | | | | | | | | | | |
pain medication he has taken since being admitted to the unit.
| | | | | | | | | |
|Assessment: His current medication order is not sufficiently managing
| | | | | | | | |
the patient's pain. He does not want to sit up or move because of the
| | | | | | | | | | | | | | |
pain he is experiencing.
| | |
Recommendation: It might be helpful to change the pain medication
| | | | | | | | | | |
order for the patient.
| | |
guided imagery - CORRECT ANSWER✔✔--mind/body intervention
| | | | |
-Concentrating on an image or series of images to treat pathological
| | | | | | | | | | |
conditions
Maslow's Hierarchy of Needs - CORRECT ANSWER✔✔--where (1)
| | | | | | | |
physiological needs are PRIORITY then (2) safety and security, (3) love
| | | | | | | | | | |
and belonging needs. (4) self esteem needs, and FINALLY (5) self
| | | | | | | | | | |
actualization needs |
The nurse planning care for a client experiencing dystocia determines
| | | | | | | | | |
that the priority is which action?
| | | | |
,1. Position changes and providing comfort measures
| | | | | |
2. Explanations to the client about what is happening
| | | | | | | |
3. Monitoring for changes in the condition of the birthing parent and
| | | | | | | | | | | |
fetus
4. Encouraging the use of breathing techniques learned in childbirth
| | | | | | | | | |
preparatory classes |
Answer: 3 |
Test-Taking Strategy: Note the strategic word, priority, and use Maslow's
| | | | | | | | |
Hierarchy of Needs theory to prioritize, remembering that physiological
| | | | | | | | | |
needs come first. The nurse needs to have knowledge of the client's
| | | | | | | | | | | |
priority needs and generate solutions. All the options are correct and
| | | | | | | | | | |
would be implemented during the care of a client with dystocia. Also
| | | | | | | | | | | |
note that the correct option is the only one that addresses both the
| | | | | | | | | | | | |
birthing parent and the fetus. Remember to use Maslow's Hierarchy of
| | | | | | | | | | |
Needs theory to help prioritize and generate solutions!
| | | | | | |
EHR system and limitations - CORRECT ANSWER✔✔--EHR AND EMR are
| | | | | | | | | |
different from eachother | |
-A health care agency often relies on the nursing history model included
| | | | | | | | | | | |
in the electronic health record (EHR) as the organizing framework for an
| | | | | | | | | | | |
assessment. However, EHR frameworks are often medically driven.
| | | | | | | |
Frameworks developed from nursing theories are more holistic and
| | | | | | | | |
patient-centered, providing a more comprehensive patient review. | | | | | |
, -When it comes to the EMR freezing it's best to notify IT or when the
| | | | | | | | | | | | | | |
computer system shuts down during data entry. The nurse should follow
| | | | | | | | | |
established protocols and prepare to re-enter data as a late entry when
| | | | | | | | | | | | |
the system is operational. Also never attempt to reboot or fix the EMR
| | | | | | | | | | | | |
system which may prolong the complication.
| | | | |
It's also not recommended to print EMR from a backup server without
| | | | | | | | | | | |
proper authorization and ensuring data privacy and security.
| | | | | | |
-patient outcome data; and use clinical decision support systems. The
| | | | | | | | | |
electronic health record (EHR) is an efficient method for documenting
| | | | | | | | | |
and managing patient health care information (see Chapter 26.)
| | | | | | | | |
Computerized physician/provider order entry (CPOE), allowing health | | | | | | |
care providers to directly enter medical orders, is a critical patient safety
| | | | | | | | | | |
initiative especially in the area of medication ordering and
| | | | | | | | | |
administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are | | | | | | | |
ways to keep all health care providers and patients informed
| | | | | | | | |
Hand Hygeine - CORRECT ANSWER✔✔--hand washing does not kill
| | | | | | | | |
microorganisms but reduces the amount of them present | | | | | | |
-four techniques: hand washing, antiseptic hand wash, antiseptic hand
| | | | | | | | |
rub, surgical hand antisepsis
| | |
-4 elements of hand washing: water, friction, soap , and time
| | | | | | | | | |
Dosage Calculation (ml, tbsp->ml) - CORRECT ANSWER✔✔-
| | | | | |
COMPLETE SOLUTIONS
SBAR Format - CORRECT ANSWER✔✔--model for effective
| | | | | | |
communication identifying Situation, Background, Assessment, and | | | | | |
Recommendation
-there are two types of ways that communication tools are used to
| | | | | | | | | | | |
communicate a patients change in condition: CUS tool (Concerned,
| | | | | | | | |
Uncomfortable, Safety) and SBAR | | |
-note to always maintain pt privacy and confidentiality
| | | | | | |
SBAR EXAMPLE : | |
Case Study: You administered 1 tablet of oxycodone HCl 5 mg/ibuprofen
| | | | | | | | | |
400 mg PO to a patient 30 minutes ago for postsurgical pain. You return
| | | | | | | | | | | | | | |
to the patient's room to evaluate the effectiveness of the medication 30
| | | | | | | | | | | |
minutes later. The patient rates his pain as an 8 on a scale of 0-10. You
| | | | | | | | | | | | | | | |
use SBAR to contact the patient's health care provider.
| | | | | | | |
Situation: The patient is rating his pain as an 8 on a scale of 0-10. He
| | | | | | | | | | | | | | | | |
had his pain medication 30 minutes ago.
| | | | | |
,|Background: The patient had a knee replacement and returned from
| | | | | | | | | |
the postanesthesia care unit 6 hours ago. He has 1 tablet of oxycodone
| | | | | | | | | | | | |
HCl 5 mg/ibuprofen 400 mg PO ordered every 6 hours. This is the first
| | | | | | | | | | | | | |
pain medication he has taken since being admitted to the unit.
| | | | | | | | | |
|Assessment: His current medication order is not sufficiently managing
| | | | | | | | |
the patient's pain. He does not want to sit up or move because of the
| | | | | | | | | | | | | | |
pain he is experiencing.
| | |
Recommendation: It might be helpful to change the pain medication
| | | | | | | | | | |
order for the patient.
| | |
guided imagery - CORRECT ANSWER✔✔--mind/body intervention
| | | | |
-Concentrating on an image or series of images to treat pathological
| | | | | | | | | | |
conditions
Maslow's Hierarchy of Needs - CORRECT ANSWER✔✔--where (1)
| | | | | | | |
physiological needs are PRIORITY then (2) safety and security, (3) love
| | | | | | | | | | |
and belonging needs. (4) self esteem needs, and FINALLY (5) self
| | | | | | | | | | |
actualization needs |
The nurse planning care for a client experiencing dystocia determines
| | | | | | | | | |
that the priority is which action?
| | | | |
,1. Position changes and providing comfort measures
| | | | | |
2. Explanations to the client about what is happening
| | | | | | | |
3. Monitoring for changes in the condition of the birthing parent and
| | | | | | | | | | | |
fetus
4. Encouraging the use of breathing techniques learned in childbirth
| | | | | | | | | |
preparatory classes |
Answer: 3 |
Test-Taking Strategy: Note the strategic word, priority, and use Maslow's
| | | | | | | | |
Hierarchy of Needs theory to prioritize, remembering that physiological
| | | | | | | | | |
needs come first. The nurse needs to have knowledge of the client's
| | | | | | | | | | | |
priority needs and generate solutions. All the options are correct and
| | | | | | | | | | |
would be implemented during the care of a client with dystocia. Also
| | | | | | | | | | | |
note that the correct option is the only one that addresses both the
| | | | | | | | | | | | |
birthing parent and the fetus. Remember to use Maslow's Hierarchy of
| | | | | | | | | | |
Needs theory to help prioritize and generate solutions!
| | | | | | |
EHR system and limitations - CORRECT ANSWER✔✔--EHR AND EMR are
| | | | | | | | | |
different from eachother | |
-A health care agency often relies on the nursing history model included
| | | | | | | | | | | |
in the electronic health record (EHR) as the organizing framework for an
| | | | | | | | | | | |
assessment. However, EHR frameworks are often medically driven.
| | | | | | | |
Frameworks developed from nursing theories are more holistic and
| | | | | | | | |
patient-centered, providing a more comprehensive patient review. | | | | | |
, -When it comes to the EMR freezing it's best to notify IT or when the
| | | | | | | | | | | | | | |
computer system shuts down during data entry. The nurse should follow
| | | | | | | | | |
established protocols and prepare to re-enter data as a late entry when
| | | | | | | | | | | | |
the system is operational. Also never attempt to reboot or fix the EMR
| | | | | | | | | | | | |
system which may prolong the complication.
| | | | |
It's also not recommended to print EMR from a backup server without
| | | | | | | | | | | |
proper authorization and ensuring data privacy and security.
| | | | | | |
-patient outcome data; and use clinical decision support systems. The
| | | | | | | | | |
electronic health record (EHR) is an efficient method for documenting
| | | | | | | | | |
and managing patient health care information (see Chapter 26.)
| | | | | | | | |
Computerized physician/provider order entry (CPOE), allowing health | | | | | | |
care providers to directly enter medical orders, is a critical patient safety
| | | | | | | | | | |
initiative especially in the area of medication ordering and
| | | | | | | | | |
administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are | | | | | | | |
ways to keep all health care providers and patients informed
| | | | | | | | |
Hand Hygeine - CORRECT ANSWER✔✔--hand washing does not kill
| | | | | | | | |
microorganisms but reduces the amount of them present | | | | | | |
-four techniques: hand washing, antiseptic hand wash, antiseptic hand
| | | | | | | | |
rub, surgical hand antisepsis
| | |
-4 elements of hand washing: water, friction, soap , and time
| | | | | | | | | |
Dosage Calculation (ml, tbsp->ml) - CORRECT ANSWER✔✔-
| | | | | |
